Complications of gastric mass screening by indirect fluororadiography.

Abstract

We studied the complications of gastric mass screening by indirect fluororadiography. During a period of 5 years, from 1998 to 2002, when we started to use a high-density, low-viscosity barium sulfate suspension in indirect fluororadiography, 1,012,976 participants were examined. Of 118 cases with complications, 100 had aspiration of barium sulfate (0.0099%, 3 admission), 4 had ileus, 8 had nausea / vomiting, 4 had constipation, one had dizziness and one had excoriation of the upper arm. The critically severe complications were barium sulfate aspiration and ileus. Elderly men and persons with recurrent disease, impaired intellect, post-laryngectomy, post-cerebral infarction and Parkinsonism were at high risk for barium sulfate aspiration. These high-risk groups should be referred to endoscopic examination rather than fluororadiography. Ileus was a critical complication, because three of four cases had perforation and peritonitis. Elderly women were at high risk for ileus or perforation. Gastric cancer screening by fluororadiography was regarded as contraindicated for participants who had past histories of ileus or limited water intake. It is therefore necessary to carefully record the clinical history and to teach participants to drink plenty of water after the examination. Anaphylactic and allergic reactions did not increase with the use of high-density barium sulfate suspension. With the increase in the number of elderly participants in mass screenings, careful interviews, informed consent regarding the merits and demerits of screening, an introduction to opportunistic screening, including endoscopic examination, and the limitation of the eligibility of participants may be necessary